Smoking Cessation in Hospitalized Smokers

Most smokers in the U.S. actually do quit smoking when hospitalized, either voluntarily or
involuntarily because of hospital's nonsmoking policy. However, the majority of them return
to smoking soon after their discharge from the hospital. A hospital stay, therefore, is a
"teachable moment" for these patients, a good opportunity to encourage them to lead a
smoke-free life after they are discharged. Research, however, has found that brief counseling
provided to smokers while they are hospitalized has limited effect. The scientific data
clearly show that smokers should be identified at the hospital, provided counseling, and
given intensive interventions with follow up extended to 1 month post discharge. Providing
such clinical services to these patients will reduce their chance of relapse to smoking and
the rate of re-hospitalization. In practice though, hospitals have had difficulty providing
even basic bedside counseling with a subgroup of patients, not to mention a much longer
follow up post-discharge with all patients.

The proposed study aims to demonstrate that state quitlines can help bridge the gap between
the recommendations from existing scientific data and the current practice by hospitals.
Quitlines deliver counseling services by telephone. This is convenient for patients because
they do not have to go anywhere in order to receive the counseling. Moreover, telephone
counseling can be delivered proactively by the counselor.

The potential impact of this study is that if this model is proven effective in a rigorous
study design, then it is likely that state quitlines across the U.S. will adopt it and start
working with hospitals that are interested in using such as system. If the new JCAHO
requirements get adopted, there will be a strong incentive for the hospitals to work with
partners like the quitlines that can help provide follow up counseling.

With the proposed project the investigators intend to establish a practical model that lends
itself to broader dissemination, while testing the effectiveness of the interventions with
the rigor of a randomized design.

Inclusion Criteria:

- 18 years or older

- Smoke >=6 Cigarettes per day

- English or Spanish speaking

- Valid phone number

- Valid address

- Gave consent to participate in study and evaluation

Exclusion Criteria:

- Hospital stay of less than 24 hours

- Inability to communicate orally

- Hypersensitivity to nicotine

- Pregnant

- Hospitalized for psychiatric treatment